FRAMINGHAM, Mass. (Sept. 7) – Fabiola DePaula’s quest for beauty took her to a condominium basement, where authorities say she paid an unlicensed doctor $3,300 for a nose job and liposuction performed on a massage table.

But something went terribly wrong and the 24-year-old nanny died, exposing what investigators say was an underground cosmetic-surgery network used by immigrants from Brazil – a country whose women are world-famous for their beauty and their willingness to go under the knife to achieve it.

“Somebody has to speak out. Go to the Brazilians, open their minds and let them know it’s dangerous,” said Jacque Foster, a friend of DePaula’s. “This is totally beyond unsafe. You have to think about what you are doing.”

Authorities believe a Brazilian doctor, Luiz Carlos Ribeiro, performed liposuction, nose jobs and Botox injections for three years in the Framingham area, mostly for the town’s large Brazilian immigrant population and mostly for cash.

Police say DePaula, a native of Brazil, went to Ribeiro for a nose job on July 27, then died three days later after the liposuction. According to the autopsy report, DePaula died of complications from the liposuction, including pulmonary fat emboli, or fat particles in the lungs.

District Attorney Martha Coakley said doctors in a hospital could have dealt with the complication, which she called a rare but known risk.

Ribeiro and his wife, Ana Maria Miranda Ribeiro, both 49, were arrested July 31 and charged with manslaughter, unauthorized practice of medicine and drug counts. The couple pleaded not guilty and remain in jail. Their attorneys declined to comment. The owner of the condo was also arrested.

The district attorney said Ribeiro was licensed to practice medicine in Brazil, but his specialty was not cosmetic surgery. Officials have not identified his specialty.

Eliana Miranda, a Brazilian immigrant who owns a clothing store in Framingham, about 20 miles west of Boston, said she doubts Ribeiro had trouble finding customers.

Cosmetic surgery is “big here too, but in Brazil, it’s much bigger,” she said. “We suffer all day in high heels, just to look good. Americans think about what is comfortable. Even the underwear is more underwear.”

Youth and beauty are positively worshipped in Brazilian culture, exemplified by the scantily clad women celebrating Carnival or sunbathing on the beach (a spectacle immortalized in the sultry song “The Girl From Ipanema.”) The best-known plastic surgeons in the country are celebrities.

Other states with large immigrant populations have also seen cases in which people fell victim to others practicing medicine or dentistry illegally. In Miami, for example, which has a large population of Brazilians and others from Latin American countries that put a heavy emphasis on female beauty, many of these cases involve cosmetic procedures.

Some Brazilians around Framingham said it is common for Brazilians to travel back to their native country for all types of operations – not just cosmetic surgery – that often cost thousands of dollars less than in the United States.

Maxine L. Margolis, a professor of anthropology at the University of Florida who specializes in Brazilian immigrants, said unlicensed doctors offering cheap procedures here could be particularly appealing to illegal immigrants, who do not want to risk being unable to return to the United States. (The district attorney’s office would not comment on DePaula’s immigration status.)

In the Framingham case, at least two other women have come forward, saying they were patients of the doctor. Authorities are using local Brazilian media and a hot line to find other potential victims and explain the risks involved in illegal surgery. Massachusetts is estimated to have more than 30,000 people of Brazilian descent, most of them in the Boston area.

“There should be a lesson learned from the death of this young woman,” the district attorney. “People think this is an extension of getting my nails done, getting my hair done.”

Foster said the sad thing is that her friend had no need for cosmetic surgery: “She was absolutely gorgeous, not only on the outside but on the inside.”

09/07/06 14:08 EDT

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